﻿<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml" >
<head>
    <title>Web Form</title>
</head>
<body>
    <table border="1">
        <colgroup><col width="160px"/><col width="50px"/><col width="50px"/><col width="50px"/></colgroup>
        <tr>
            <td align="right">Last Name</td>
            <td colspan="3"><input type="text" size="50px" /></td>
        </tr>
        <tr>
            <td  align="right">First Name</td>
            <td colspan="3"><input type="text" size="50px" /></td>
        </tr>
        <tr>
            <td  align="right">Adress</td>
            <td colspan="3"><textarea rows="3" cols="38"></textarea></td>
        </tr>
        <tr>
            <td  align="right">City</td>
            <td><input type="text" size="30px"/></td>
            <td>State</td>
            <td><input type="text" size="5px"/></td>
        </tr>
        <tr>
            <td  align="right">Zip/Postal Code</td>
            <td colspan="3"><input type="text" size="10px"/></td>
        </tr>
        <tr>
            <td  align="right">Country</td>
            <td colspan="3">
                <select name="country">
                <option value="Value 1" selected="selected">Bulgaria</option>
                <option value="Value 2">England</option>
                <option value="Value 3">Germany</option>
                <option value="Value 4">USA</option>
                <option value="Value 5">France</option>
                </select>
            </td>
        </tr>
        <tr>
            <td  align="right">Phone (country code, area code, number)</td>
            <td colspan="3">(+<input type="text" size="5px"/>) <input type="text" size="5px"/> - <input type="text" size="20px"/></td>
        </tr>
        <tr>
            <td  align="right">Email</td>
            <td colspan="3"><input type="text" size="50px"/></td>
        </tr>
        <tr>
            <td  align="right">Birth date</td>
            <td colspan="3">Month<input type="text" size="2px"/> Day<input type="text" size="2px"/> Year(4 digit)<input type="text" size="8px"/></td>
        </tr>
        <tr>
            <td  align="right">Gender</td>
            <td colspan="3">
                <select name="gender">
                <option value="Value 1" selected="selected">Male</option>
                <option value="Value 2">Female</option>
                </select>
            </td>
        </tr>
        <tr>
            <td  align="right">Starting date</td>
            <td colspan="3">
                <input type="radio" name="date" value="Spring" /> Spring
                <input type="radio" name="date" value="Summer" /> Summer
            </td>
        </tr>
        <tr>
            <td  align="right">Comments/Questions</td>
            <td colspan="3"><textarea rows="5" cols="38"></textarea></td>
        </tr>
        <tr>
            <td colspan="4" align="center" style="background-color:Lime">
                <input type="submit" name="submit" value="Submit" />  <input type="reset" name="resetFormButton" value="Clear This Form" />
            </td>
        </tr>
    </table>
</body>
</html>
